慢性乙型肝炎病毒感染者用药行为风险的“知识-态度-行为模式”研究

目的：调查慢性乙型肝炎病毒（HBV）感染患者的安全用药知识及安全用药行为的情况,针对风险点,为慢性HBV感染患者提供更准确、更有效的合理用药科普宣传方案。方法：对入组的慢性HBV感染患者进行用药安全行为风险KAP问卷调查,汇总问卷调查数据进行分析评估,根据评估结果设计合理用药科普内容,并进行科普宣传,经科普宣传后再进行第二次问卷调查。对比科普宣传前后的问卷调查结果,分析评估科普宣传的成效。结果：对比科普宣传前后数据,安全用药知识的知晓情况（K）,11个问题有统计学差异,总体分析科普宣教在慢性HBV感染患者对安全用药知识的知晓方面,具有明显成效;安全用药行为情况（P）,12个问题有统计学差异,说明对规范用药行为方面有进行科普宣传的迫切性和必要性;对用药知识的教育活动的看法与观点（A）,4个问题均有统计学差异,说明受试者对科普培训收获比较大,愿意继续接受用药知识科普宣传。结论：通过科普宣教显著增强了受试者安全用药意识,改善安全用药行为,提高安全用药科普宣传的接受度,并为制定慢性HBV感染患者安全用药科普干预内容和方法的精准设置提供依据。     

What cancer care providers need to know about CAM: the CAM‐Cancer project

‘CAM‐Cancer’ is the name of a project entitled ‘Concerted Action for Complementary and Alternative Medicine Assessment in the Cancer Field’ (CAM‐Cancer). The CAM‐Cancer website (< http://www.cam‐cancer.org >) is an open‐access information resource on CAM for cancer. It provides synthesised evidence‐based information for healthcare professionals drawing on the current research status of the efficacy/effectiveness and safety of CAM for cancer. The information is presented as ‘CAM‐summaries’, which are short and concise documents presenting background information as well as an appraisal of the evidence of efficacy and safety. CAM‐summaries are peer‐reviewed and annually updated. The fully documented and published methodology ensures that CAM‐summaries are written in an independent and non‐judgemental way to maximise their use amongst health professionals. The project is led by an international panel of experts in cancer care and/or CAM research, and supported by a wide network of professionals and cancer organisations. Originally funded by the European Commission within the Fifth Framework Programme, it is now managed by the National Research Center in Complementary and Alternative Medicine (NAFKAM) at the University of Tromsø, Norway. The project is entirely non‐profit and receives no commercial funding.     

What is the quality of drug safety information for patients: An analysis of REMS educational materials

Background

Poor‐quality patient drug information has been identified as a major cause of preventable medication errors in the United States. The US Food and Drug Administration (FDA) has the authority to require marketing authorization holders of medicinal products to implement risk evaluation and mitigation strategies (REMS) to ensure that the benefits of a drug or biological product outweigh its risks. Aside from medication guides, no research has been conducted to assess the quality of patient‐targeted REMS materials, including whether, and to what extent, patients find these materials understandable and actionable.

Purpose

To describe the readability, understandability, and actionability of patient educational materials in currently approved REMS programs, and to highlight opportunities for improving both the quality and effectiveness of these important drug safety tools.

Methods

Seventy‐seven REMS programs were identified from the FDA REMS database. We excluded medication guides (MGs) from our analysis because of the fact that there is a mandatory MG template. Based on this, we identified a total of 27 (non‐MG) REMS patient materials on the FDA REMS website for analysis purposes. The materials were tested for readability using the Lexile Measure, the Gunning Fog Index, and Flesch Kincaid and then assessed using the Patient Education Materials Assessment Tool for printable materials, for understandability and actionability.

Results

Twenty‐three of 77 (30%) REMS programs used educational materials to communicate serious risks to patients, yielding a total of 27 REMS patient materials for analysis. The median readability score for these materials was at a ninth‐grade reading level or higher. While most (89%) of these patient education materials met established criteria for being understandable, less than half (49%) were deemed actionable.

Discussion

Currently approved REMS patient materials fell short in terms of recommended reading level, and over half did not meet recommended standards for actionability. Developers of these materials should apply plain language principles when design these materials to improve their readability and to assess both understandability and actionability in order to increase the effectiveness when distributed to patients.     

基于《中国老年人潜在不适当用药判断标准(2017版)》的老年患者不适当用药评价研究

目的 通过分析养老机构老年多重用药患者潜在不适当用药的现状,为临床药师推进老年患者的合理用药提供参考依据。方法 随机抽取上海某养老机构老年多重用药患者258例,以《中国老年人潜在不适当用药判断标准（2017版）》为评价依据进行分析,总结检出的潜在不适当用药（PIM）情况。结果 研究对象的平均年龄为（82.57±5.56）岁,平均服药种数（6.98±1.96）种,共检出160名（62.0%）患者存在PIM。其中,与药物有关的潜在不适当用药206项,与疾病状态有关的潜在不适当用药91项。结论 养老机构老年多重用药患者潜在不适当用药情况突出,临床药师依托多学科评估团队介入药物治疗,对发现和消除PIM及优化用药方案起到重要作用。